There was a collective sigh of relief at the news that Pfizer’s early results show an effective COVID-19 vaccine may be on the horizon. Pfizer’s boss trumpeted the announcement by declaring: “Today is a great day for science and humanity.”

A vaccine breakthrough is indeed great news but sadly it’s not for the whole of humanity — just a small fraction. Over 80 percent of the Pfizer vaccine stocks up to the end of next year have already been hoarded by rich countries such as the UK, US, EU, Japan, and Canada. Collectively these countries represent just 14 percent of the global population.

If Pfzier’s vaccine is approved, the majority of the world’s population — living mainly in low- and middle-income countries — will not be able to get anywhere near it. And it’s the same story with Moderna, who has declared that their vaccine is nearly 95 percent effective. Seventy-eight percent of their doses have already been bought up by rich countries, representing just 12 percent of the global population.

It is likely that global supplies will be limited even further because Pfizer and its partner BioNTech’s patent on the vaccine means no other company can make or sell that vaccine for a minimum of twenty years. This provides the basis for a legal monopoly — and with no competition, Pfizer decides who gets the vaccine and at what price.

On these terms, it’s no surprise that most of the vaccines have gone to the highest bidders and Pfizer/BioNTech are set to walk away with bonanza profits, making an estimated $13 billion next year from the vaccine.

All of this sounds hugely unfair, if not immoral. And yet that is exactly how the system has worked for decades. The pharmaceutical industry is a profit-driven machine that uses patent monopolies to charge the highest prices for life-saving treatments while reaping the highest profits.

It’s become one of the most profitable in the world, but at the expense of billions of patients who have struggled to access affordable basic and life saving treatments. This is bad enough in normal times but during a global pandemic, it could be truly disastrous.

So what can be done about it? Well, no one company can satisfy global demand. If getting actual physical stocks is the problem, then the obvious thing to do is for companies like Moderna and Pfizer to share its technological know-how and the rights to make the vaccine with other companies. Mobilizing more manufacturers will increase global supply so that more people can access the vaccine and prevent price gouging.

The World Health Organization launched a mechanism earlier this year — COVID-19 Technology Access Pool — to facilitate sharing of technological know-how and intellectual property rights to allow any company or any country to access much-needed vaccines and treatments. However, only forty countries have so far have joined this global pool and pharmaceutical companies have condemned the scheme, with the Pfizer boss dismissing it as “nonsense.”

This reaction may not be that surprising. After all, why would a profit-making company ever give away its commercial secrets and intellectual property to competitors? It has actually been done before.

The Medicines Patent Pool, a UN-backed public health organization, has helped to negotiate voluntary sharing with generics companies to improve access to HIV, TB, and Hepatitis C treatments in low- and middle-income countries. And Moderna has pledged not to enforce its patents during this pandemic, but has not made any public commitments on sharing its technological know-how which will be crucial for other companies to replicate the vaccine.

Public funding has played a major role in the search for a COVID-19 vaccine. Globally, over $5.5 billion has been poured into COVID-19 vaccine research and development. Even with Pfizer’s claims that they have not received any government funding, they have benefited from the advance purchases by rich governments of a billion doses of what was an unproven vaccine, while BioNTech has received €375 million in direct funding from the German government.

The very science that the Pfzier vaccine and indeed other leading vaccine candidates are based on — a spike protein technology — was funded by the US government. It shouldn’t be controversial that publicly-funded vaccines prioritize public health outcomes, including commitments on pricing, open licensing, and sharing manufacturing know-how.

Ultimately, voluntary sharing of know-how and patent rights is exactly that — it’s voluntary and depends on the piecemeal goodwill of companies to do the right thing. But right now, doing the right thing in the face of global pandemic shouldn’t be optional.

The governments of India and South Africa have put a proposal on the table of the World Trade Organization to suspend the global trade rules that prop up Big Pharma monopolies. The proposed suspension would cover COVID-19 health products and last until widespread vaccination is in place and global herd immunity achieved.

Suspending these unjust rules would be a massive game changer — it would break up Big Pharma monopolies on COVID-19 vaccines and treatments, allowing as many suppliers as possible to maximize global supply. Countries in the Global South are welcoming this proposal, while just a handful of rich countries are opposing it.

Instead countries like the UK are relying on a global vaccine purchasing scheme, the Covax Facility led by the Gates Foundation, to tackle the problem of stark inequality of vaccine access. The idea is to bring countries together to purchase collectively and distribute equitably.

But the UK government is making big commitments to the Covax Facility, while at the same time undermining it by securing deals to hoard vaccines for the UK only outside of the scheme. Its actions are fueling vaccine nationalism with other rich countries also cutting their own deals to secure supplies.

It is estimated that 51 percent of global stocks are already bagged by rich countries, raising the question of whether there are even enough vaccines for Covax to buy. Ultimately, the Covax Facility is unwilling to challenge Big Pharma monopolies or support the global pool, and so it will end up scrabbling around for scraps after rich countries have taken their pickings.

If there were ever a time to reorientate the global pharmaceutical system to prioritize public health over corporate profits, it is now. There is just too much at stake to allow Big Pharma monopolies and profiteering to restrict access to crucial COVID-19 vaccines and treatments.

The desperation to see the end of national lockdowns and social restrictions is felt not just in this country but in every country affected. Every country deserves to have access to the vaccines and treatments to combat this virus, and the only way this can happen is for pharmaceutical companies to allow and support other companies to help ramp up supplies.

If they won’t do it voluntarily, then governments need to step in and make it happen.